Risk Factors of Mechanical Ventilation in Premature Infants During Hospitalization

Abstract

Background The purpose of this study was to identify the risk factors for premature neonates requiring mechanical ventilation. Methods Premature neonates admitted to Chengdu Women’s and Children’s Central Hospital between July 2014 and December 2020 were retrospectively included in this study. Clinical and demographic factors were collated. Univariate and multivariate logistic regression analyses were conducted to identify the risk factors for premature infants requiring mechanical ventilation. Results A total of 1262 premature neonates participated in the study. Among them, 423 (33.53%) neonates required mechanical ventilation, whereas 839 (66.48%) neonates did not require mechanical ventilation. Multivariate logistic regression analysis determined that a lower Apgar score at 5 min (OR = 0.595, 95% CI: 0.472–0.74; P < 0.001), lower gestational age (very preterm) (OR = 11.745, 95% CI: 4.362, 31.619, P < 0.001), lower systolic blood pressure (OR = 0.864, 95% CI: 0.812–0.917, P = 0.001), lower diastolic blood pressure (OR = 0.894, 95% CI: 0.831–0.96, P = 0.002), higher respiratory rate (OR = 1.292, 95% CI: 1.238–1.355, P < 0.001), increased C-reactive protein levels (OR=1.044, 95% CI: 1.003–1.086, P = 0.036), and presence of patent ductus arteriosus (OR = 2.174, 95% CI: 1.185–3.972, P = 0.012) were independently associated with an increased possibility of adopting mechanical ventilation in premature infants. ROC analysis demonstrated that the predicted power for premature neonates requiring mechanical ventilation was 0.855 (95% CI: 0.808–0.902, P < 0.001). Conclusion In conclusion, we determined that a lower Apgar score at 5 min, lower gestational age, lower systolic blood pressure, lower diastolic blood pressure, higher respiratory rate, increased C-reactive protein levels and presence of patent ductus arteriosus were independently associated with an increased possibility of adopting mechanical ventilation in premature infants.

Construção e validação de diagnósticos de enfermagem para recém-nascidos prematuros

“…Quanto menor a idade gestacional, maior a chance de um prematuro necessitar de assistência ventilatória, e devido a imaturidade pulmonar, a ventilação mecânica é o tratamento de suporte de vida para esses pacientes. Mesmo com os tratamentos mais modernos e a diminuição de prematuros que necessitem de intubação e ventilação mecânica, uma proporção de deles ainda necessitam de suporte de um ventilador (25) .…”

Construction and validation of nursing diagnoses for premature newborns

“…The lower the gestational age, the greater the chance of a premature baby needing ventilatory assistance and due to the immaturity of the lungs, mechanical ventilation is the life support treatment for these patients. Even with the most modern treatments and the reduction in premature infants requiring intubation and mechanical ventilation, a proportion of them still need ventilator support (25) .…”

Complications of Preterm Birth—The Importance of Care for the Outcome: A Narrative Review

“…Cuddling and contact with the mother’s chest should be provided even if the baby is on mechanical ventilation. For premature babies, there are mechanical ventilation systems that allow babies to breathe until their lungs and the respiratory center in the brain matures [ 41 ].…”